Why is caustic soda dangerous

Studies from South Africa and Nigeria reported that corrosive agent was readily available and within reach of the affected patients [ 13 , 18 ]. This is because there are no restrictions to sale and handling of caustic chemicals in many developing countries including Ghana.

Legislations to control the usage of caustic soda and ensure that containers are child-proof have been advocated for a long time [ 19 ]. It is important that they are enacted and enforced now. This is because the absence or ineffective regulation of potentially harmful chemical agents makes the environment unsafe and constitutes substantial risk to both children and adults [ 4 ].

Moreover, it is apparent that Soap makers often forget and do not put left-over caustic soda into hiding but always preferred to finish the soap process before. As a result, preschool children get access to these corrosive substances.

The fact that the caustic substances are mixed with other substances and left in the open without proper safety measures also influences children access to and risk of ingestion.

Only 1 out of 57 children was accidentally administered with the corrosive substance by a relative. The event to this action per the study is due to poor storage coupled with irresponsible parenting. The questions to ask are: How can caustic soda, a corrosive substance, be stored in a bottle and be placed at the same window where children drugs are also kept? And why should a parent instruct a 10 year old child to administer drugs to a preschool child?

Obviously this mix-up where the caustic soda is accidentally administered is bound to happen. Children are to be protected by their parents or guardians and the society at all times. In our study, the majority of children with caustic soda ingestions were in families whose parents did not have formal education, ply local soap making, undertake petty trading and farming as occupation. Unfortunately, the high costs of hospital admission, surgery, laboratory and radiologic examinations, coupled with the high cost of transportation to the referral centre for those living farther away are usually beyond the reach of many of these individuals resulting in late presentation of the injuries and further complications [ 20 ].

Fluoroscopy evaluation of the oesophagus for instance, in these victims often involves the use of water-soluble contrast agents which are very expensive and as such result in deferral of such diagnostic examinations. Some researchers have also observed that repeated hospital visits also results in loss of work for parents and neglect of other children at home [ 11 ].

Since many of these respondents have four or more number of children, their children may suffer unduly for some of these irresponsible activities that have resulted in the caustic soda ingestions. Poor storage precautions where caustic soda substances are stored in soft drink and water bottles in accessible places and lackadaisical attitudes on the part of traditional soap makers, poor handling of left-over caustic soda during soap making and accidental administration of the corrosive substances influenced caustic soda ingestion in children below 5 years.

Training of children to drink directly from bottles also influences caustic soda ingestion in children under 5 years. Corrosive ingestion is a considerable burden especially among people with little or no formal education and poor socio-economic status.

This group of people should be targeted for education about creating safe working environments. Educating parents and soap makers will increase awareness of dangers associated with caustic soda and other corrosive substance ingestions. This is needful to guard against indiscriminate handing of these corrosive agents. Enforcement of chemical hazards legislation to control the usage of caustic soda is required to ensure that containers are child-proof to prevent easy access to corrosive agents by children.

A suggested algorithm for preventing caustic soda ingestion in children under 5 years is presented in Appendix 1. The study used relatively small sample size. Also, the study focused on a referral population to a tertiary hospital, so it did not include children with minor ingestions that were managed locally without referral.

Contini S, Scarpignato C. Caustic injury of the upper gastrointestinal tract. A comprehensive review. World J Gastroenterol. Epidemiology of pediatric surgical admissions to a government referral hospital in the Gambia. Bull World Health Organ. Corrosive oesophagitis in Nigeria: clinical spectrums and implications. Trop Doct. Oesophageal corrosive injuries in children: a forgotten social and health challenge in developing countries.

Bull WHO. Weldon E. Accidental injuries of preschool children in Ghana. In: Roscoe C, editor. Ghana social, economic and political issues. New York: Nova Science publishers; Only trained personnel should work with this product. Immediately report leaks, spills or failures of the safety equipment e.

Avoid generating vapours or mists. Avoid generating dusts. Use corrosion-resistant tools and equipment. Never add water to a corrosive. Always add corrosives slowly to COLD water. Never reuse empty containers, even if they appear to be clean.

Keep containers tightly closed when not in use or empty. Storage: Store in an area that is: cool, dry, well-ventilated, separate from incompatible materials. Keep amount in storage to a minimum. Store in the original, labelled, shipping container.

Vent drums to prevent pressure buildup. Do not handle swollen drums. Get expert advice. Empty containers may contain hazardous residue. Store separately. Keep closed. Contain spills or leaks by storing containers in trays made from compatible materials. Since legislation varies by jurisdiction, contact your local jurisdiction for exact details. A list of which acts and regulations that cover exposure limits to chemical and biological agents is available on our website.

Please note that while you can see the list of legislation for free, you will need a subscription to view the actual documentation. Engineering Controls: Use a local exhaust ventilation and enclosure, if necessary, to control amount in the air. It may be necessary to use stringent control measures such as process enclosure to prevent product release into the workplace.

Use a corrosion-resistant exhaust ventilation system separate from other ventilation systems. Exhaust directly to the outside, taking any necessary precautions for environmental protection.

A face shield with safety goggles may also be necessary. Skin Protection: Wear chemical protective clothing e. Inhalation of sodium hydroxide is immediately irritating to the respiratory tract. Swelling or spasms of the larynx leading to upper-airway obstruction and asphyxia can occur after high-dose inhalation.

Inflammation of the lungs and an accumulation of fluid in the lungs may also occur. Children may be more vulnerable to corrosive agents than adults because of the relatively smaller diameter of their airways.

Children may be more vulnerable because of relatively increased minute ventilation per kg and failure to evacuate an area promptly when exposed.

People with asthma or emphysema may be more susceptible to the toxicity of this agent. Skin contact with solid sodium hydroxide or its concentrated solutions can cause severe burns with deep ulcerations.

Burns appear soft and moist and are very painful. Although contact with concentrated solutions causes pain and irritation within 3 minutes, contact with dilute solutions may not cause symptoms for several hours.

Because of their relatively larger surface area:body weight ratio, children are more vulnerable to toxicants affecting the skin. Eye exposure may produce diffuse or localized blood vessel clots and an accumulation of fluid in the eye. Softening, sloughing, and ulcerations of the cornea may occur. Ulcerations may continue to progress for many days. Severe injury can lead to clouding of the eye surface and blindness.

Ingestion of sodium hydroxide can cause spontaneous vomiting, chest and abdominal pain, and difficulty swallowing with drooling. Corrosive injury to the mouth, throat, esophagus, and stomach is extremely rapid and may result in perforation, hemorrhage, and narrowing of the gastrointestinal tract. Cataracts, glaucoma, adhesion of the eyelid to the cornea, blindness, and loss of the eye may occur after eye exposure.

Cancer of the esophagus has been reported 15 to 40 years after the formation of corrosion-induced strictures. However, it is believed that these cancers were the result of tissue destruction and scar formation rather than a direct cancer-causing action of sodium hydroxide.

Severe inhalation injuries may cause persistent hoarseness and reactive airways dysfunction syndrome RADS , a chemically- or irritant-induced type of asthma. Chronic exposure to dusts or mists of sodium hydroxide may lead to ulceration of the nasal passages.

Chronic skin exposures can lead to dermatitis. Ingestion may lead to perforation of the gastrointestinal tract or stricture formation. Chronic exposure may be more serious for children because of their potential longer latency period. Sodium hydroxide has not been classified for carcinogenic effects. See Potential Sequelae above. Sodium hydroxide dissociates within the body and would not reach the reproductive organs in an unchanged state.

No data were located concerning reproductive endpoints in humans exposed to sodium hydroxide. Sodium hydroxide is not teratogenic in rats. Sodium hydroxide is not included in Reproductive and Developmental Toxicants , a report published by the U. General Accounting Office GAO that lists 30 chemicals of concern because of widely acknowledged reproductive and developmental consequences.

Rescuers should be trained and appropriately attired before entering the Hot Zone. If the proper equipment is not available, or if rescuers have not been trained in its use, assistance should be obtained from a local or regional HAZMAT team or other properly equipped response organization.

Respiratory Protection : Positive-pressure, self-contained breathing apparatus SCBA is recommended in response situations that involve exposure to potentially unsafe levels of sodium hydroxide. Skin Protection : Chemical-protective clothing is recommended because sodium hydroxide can cause irritation or skin burns. Quickly access for a patent airway, ensure adequate respiration and pulse.

If trauma is suspected, maintain cervical immobilization manually and apply a cervical collar and a backboard when feasible. If victims can walk, lead them out of the Hot Zone to the Decontamination Zone. Victims who are unable to walk may be removed on backboards or gurneys; if these are not available, carefully carry or drag victims to safety.

Consider appropriate management of chemically contaminated children, such as measures to reduce separation anxiety if a child is separated from a parent or other adult. If exposure levels are determined to be safe, decontamination may be conducted by personnel wearing a lower level of protection than that worn in the Hot Zone described above.

Stabilize the cervical spine with a collar and a backboard if trauma is suspected. Administer supplemental oxygen as required. Assist ventilation with a bag-valve-mask device if necessary.

Rapid decontamination is critical. Victims who are able may assist with their own decontamination. Rescuers should wear protective clothing and gloves while treating patients whose skin is contaminated with sodium hydroxide. Immediately brush any solid material from clothes, skin, or hair while protecting the victim's eyes.

Quickly remove contaminated clothing and flush exposed areas with water for at least 15 minutes. Double-bag contaminated clothing and personal belongings. Use caution to avoid hypothermia when decontaminating children or the elderly.

Use blankets or warmers when appropriate. Flush exposed or irritated eyes with plain water or saline for at least 30 minutes. Remove contact lenses if easily removable without additional trauma to the eye, otherwise sodium hydroxide trapped beneath the lens will continue to damage the eye. If pain or injury is evident, continue irrigation while transferring the victim to the Support Zone. In cases of ingestion, do not induce emesis.

For swallowed poison, the person may receive: Blood tests. Chest x-ray. ECG electrocardiogram, or heart tracing. The placement of a camera down the throat to see the extent of burns to the esophagus and the stomach. Intravenous fluids IV, fluids given through a vein. Medicines to treat symptoms. For inhaled poison, the person may receive: Blood tests. Breathing support, including oxygen and a tube through the mouth or nose into the lungs.

Camera is placed down the throat to see burns in the airways and lungs. For skin exposure, the person may receive: Irrigation washing of the skin.

Perhaps every few hours for several days. Skin debridement surgical removal of burned skin. Ointments applied to the skin. For eye exposure, the person may receive: Extensive irrigation to flush out the eye Medicines. Outlook Prognosis. Alternative Names.